title: A pilot methodology study for the photographic assessment of post-inflammatory hyperpigmentation in patients treated with tretinoin.
abstract: BACKGROUND
  Post-inflammatory hyperpigmentation (PIH) is a common occurrence in patients with acne vulgaris, particularly in those with skin of colour.
  
  
  OBJECTIVE
  A previous study has demonstrated the benefit of tretinoin (retinoic acid) in the treatment of PIH; however, there is currently no standard protocol to evaluate change in PIH following treatment. Based on these findings, we performed a pilot, exploratory, blinded, intraindividual-controlled methodology study that consisted of a photographic assessment protocol with facial mapping.
  
  
  METHODS
  The study was based on a secondary analysis of a phase 4, community-based trial of 544 acne patients who were treated with tretinoin gel microsphere 0.04% or 0.1%. Only patients with Fitzpatrick types III-V (skin of colour) were included in the study; subjects with Fitzpatrick skin type VI were excluded because the photographic assessment did not allow for proper evaluation.
  
  
  RESULTS
  Despite the small number of subjects evaluated (n=25), the results revealed consistent assessment of improvement in PIH between two independent graders (weighted κ=0.84).
  
  
  CONCLUSIONS
  Further study with a larger population is recommended to validate the accuracy of this method.
authors.affiliation: R&D Dermatology, Research Development & Medical Affairs, J&J Group of Consumer Companies, Paris, France.
authors.forename: A B
authors.initials: AB
authors.lastname: Rossi
authors.forename: J J
authors.initials: JJ
authors.lastname: Leyden
authors.forename: A S
authors.initials: AS
authors.lastname: Pappert
authors.forename: A
authors.initials: A
authors.lastname: Ramaswamy
authors.forename: A
authors.initials: A
authors.lastname: Nkengne
authors.forename: R
authors.initials: R
authors.lastname: Ramaswamy
authors.forename: M
authors.initials: M
authors.lastname: Nighland
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000188:drug therapy*; D003872:Dermatitis / Q000150:complications*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D010781:Photography; D010859:Pigmentation Disorders / Q000139:chemically induced / Q000150:complications / Q000473:pathology*; D010865:Pilot Projects; D014212:Tretinoin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D003879:Dermatologic Agents; D014212:Tretinoin